CARPHA > Laboratory User Manual - Laboratory Testing Services

Laboratory Testing Services

This section outlines investigations offered by all the departments of the laboratory. These guidelines are applicable for routine specimen referrals.

Please note - Potential outbreaks are managed on a case by case basis following contact with the Laboratory and Epidemiology divisions for further guidance.

Matrix of Disease/Aetiology Specimen Type/s Diagnostic Method and Turnaround Times
*For instructions on specimen collection and transport conditions, please refer to Annex 2

Disease/Aetiologic Agent	Method	Specimen	TAT (Days)	Comment
Bordetella pertussis	PCR	Nasopharyngeal or throat swab (collected 0 – 3 weeks from onset of cough)	7	Performed at CARPHA for countries without testing capability
Chikungunya	PCR*	Acute serum (collected 1-5 days from onset of symptoms)	7	Performed at CARPHA for outbreaks
Chikungunya	IgM ELISA	Convalescent serum (collected 6 - 21 days from onset of symptoms)	14	Performed at CARPHA for outbreaks
Cholera	Serotyping and Identification	Isolate in maintenance media Stool in Cary Blair media	7	Performed at CARPHA for countries without testing capability
Dengue Fever	PCR*	Acute serum (collected 1 - 4 days from onset of symptoms)	7	Performed at CARPHA for countries without testing capability
Dengue Fever	IgM ELISA	Convalescent serum (collected 5 - 15 days from onset of symptoms)	14
Influenza and other respiratory viruses - Parainfluenza 1 - 3, Metapneumovirus, Adenovirus, Rhinovirus, Middle East Respiratory Syndrome Coronavirus (MERS-CoV), COVID-19*** Respiratory Syncytial Virus, Enterovirus-D68	PCR**	Nasopharyngeal and Oropharyngeal swabs (NPS, OPS) or other respiratory samples (please see User Manual)	7	Performed at CARPHA for countries without testing capability
Leptospirosis	PCR	Whole Blood with anticoagulant (collected > 5 days from onset of symptoms)	7	Performed at CARPHA for countries without testing capability
Malaria	PCR	Blood	7	Performed at CARPHA for countries without testing capability Contact CARPHA for discussion before submitting
Mayaro virus	PCR	Serum (collected < 7 days from onset of symptoms)	7	Performed at CARPHA for countries without testing capability Contact CARPHA for discussion before submitting
Measles virus	ELISA IgM	Serum - Acute sample (collected < 7 days after onset of rash)	4	Performed under EPI programme Please check with the EPI manager in-country to ensure appropriate recording of samples prior to submission to CARPHA
	ELISA IgG	Serum - Convalescent sample (collected 10 to 21 days after collection of acute sample)
	PCR	NPS (collected < 7 days after onset of rash) Urine (collected < 15 days after onset of rash) NOTE: Urine must be paired with NPS
Meningitis infection (due to Neisseria meningitidis)	Antimicrobial Resistance (AMR) testing;	Isolate in BHI with glycerol or on Chocolate agar	7-14	Performed at CARPHA for countries without testing capability Isolates to be submitted to CARPHA for further characterization.
Meningitis/Sepsis (due to Streptococcus pneumoniae or Haemophilus influenzae)	Serotyping (Meningococcus only)	Isolate in BHI with glycerol or on Chocolate agar	7-14
Mumps virus	PCR Virus Isolation	Oral swab (collected 5 days from onset of symptoms)	7 14	Please check with the EPI manager in-country to ensure appropriate recording of samples prior to submission to CARPHA
Norovirus	PCR	Stool	7	Performed at CARPHA for countries without testing capability
Plague - Yersinia pestis	Culture Antimicrobial Resistance (AMR) testing;	Blood Biopsy material from bubo	14	CARPHA: to be contacted for discussion if necessary Sent to CARPHA's Reference Laboratory
Polio Virus	PCR Virus Isolation	Stool (No preservative) CSF	7 14-21	Performed under EPI programme Please check with the EPI manager in-country to ensure appropriate recording of samples prior to submission to CARPHA
Non-polio enteroviruses (NPEV)	PCR	Serum, stool, NPS, Eye swabs, oral fluids (Collect specimens <7days days from onset of symptoms)	7	Performed at CARPHA for countries without testing capability
Rabies (in humans)				Contact CARPHA for discussion before submitting (Sent to CARPHA's Reference Laboratory)
Rotavirus	Ag ELISA	Stool	7	Performed for countries without testing capability in outbreak situations. Please contact CARPHA for discussion
Rubella virus	ELISA IgM	Serum - Acute sample (collected < 7 days after onset of rash)	4	Performed under EPI programme Please check with the EPI manager in-country to ensure appropriate recording of samples prior to submission to CARPHA
	ELISA IgG	Serum - Convalescent sample (collected 10 to 21 days after collection of acute sample)
	PCR (Being implemented)	NPS (collected < 7 days after onset of rash) Urine (collected < 15 days after onset of rash) NOTE: Urine must be paired with NPS
Salmonellosis	Serotyping	Isolate in Maintenance media	7 - 14	Performed at CARPHA for countries without testing capability Isolates to be submitted for further characterization
Shigellosis	Serotyping	Isolate in Maintenance media	14	Performed at CARPHA for countries without testing capability Isolates to be submitted for further characterization
Toxoplasmosis	ELISA IgG ELISA IgM	Serum, (collected 7 days after onset of symptoms)	14	Performed at CARPHA for countries without testing capability
Tuberculosis (Pulmonary & Extra-pulmonary)	Identification (PCR) Drug Sensitivity Testing (PCR)	Sputum, Extrapulmonary samples	4	Performed at CARPHA for countries without testing capability Selected specimens sent to CARPHA's Reference Laboratory
Typhoid and paratyphoid fever	Identification Serotyping	Isolate in maintenance media	7	Performed at CARPHA for countries without testing capability
West Nile Virus	PCR	CSF/Serum, (collected 7 days after onset of symptoms)	7	Performed at CARPHA for countries without testing capability Contact CARPHA for discussion before submitting
Yellow fever	PCR	Single serum	7	Performed at CARPHA for countries without testing capability Contact CARPHA for discussion before submitting
Zika	PCR* IgM ELISA	Serum CSF, Urine, Amniotic fluid NOTE: All of these must be paired with serum sample	7 14	Performed at CARPHA for countries without testing capability. Zika IgM not done during Dengue outbreaks.

*	Samples submitted for Chikungunya, Dengue or Zika that will be tested by PCR are run on a Trioplex panel so there will be results for all three agents
**	Samples submitted for respiratory syndromes are analysed using an algorithm in which they are first tested for Influenza
***	Turnaround time is 24 to 48hours

Specialized Test Panels

Performed on The BioFire^® FilmArray^® system

CARPHA must be contacted before submitting samples to be tested by this method

MENINGITIS ENCEPHALITIS PANEL Sample: 0.2 mL of CSF	RESPIRATORY PANEL Sample: 0.3 mL of nasopharyngeal swab stored in transport medium	GASTROINTESTINAL PANEL Sample: 0.2 mL stool in Cary Blair transport medium
BACTERIA
Escherichia coli K1 Haemophilus influenzae Listeria monocytogenes Neisseria meningitidis Streptococcus agalactiae Streptococcus pneumoniae	Bordetella pertussis Bordetella parapertussis Chlamydophila pneumoniae Mycoplasma pneumoniae	Campylobacter (jejuni, coli, and upsaliensis) Clostridium difficile (toxin A/B) Plesiomonas shigelloides Salmonella Yersinia enterocolitica Vibrio (parahaemolyticus, vulnificus, and cholerae) DIARRHEAGENIC E. coli / Shigella Enteroaggregative E. coli (EAEC) Enteropathogenic E. coli (EPEC) Enterotoxigenic E. coli (ETEC) lt/st Shiga-like toxin-producing E.coli (STEC) stx1/stx2 E. coli O157 Shigella/Enteroinvasive E. coli (EIEC)
VIRUSES
Cytomegalovirus (CMV) Enterovirus (EV) Herpes simplex virus 1 (HSV-1) Herpes simplex virus 2 (HSV-2) Human herpesvirus 6 (HHV-6) Human parechovirus (HPeV) Varicella zoster virus (VZV)	Adenovirus Coronavirus 229E Coronavirus HKU1 Coronavirus OC43 Coronavirus NL63 Human Metapneumovirus Human Rhinovirus/Enterovirus Influenza A Middle East Respiratory Syncial CoronaVirus (Mers-CoV) Influenza A/H1 Influenza A/H1-2009 Influenza A/H3 Influenza B Parainfluenza (1 – 4) RSV	Adenovirus F40/41 Astrovirus Norovirus GI/GII Rotavirus A Sapovirus (I, II, IV, and V)
YEASTS
Cryptococcus neoformans/gattii
PARASITES
		Cryptosporidium Cyclospora cayetanensis Entamoeba histolytica Giardia lamblia

Entomology Specimen Referrals

The following table lists information relevant to the collection and testing of specimens for Entomology investigations.

Note: All specimens sent to the Entomological unit must be accompanied by the following information:

Method of specimen collection
Date and time of specimen collection
Name of specimen collector
Country and location
Type of habitat (from which collection was made)

Test	Specimen Recommended	Notes	Turnaround Time (Calendar Days)
Insecticide resistance	Aedes aegypti mosquito eggs	On removal from ovitraps, the paper containing eggs should be placed in a container lined with damp paper towels. After 2-3 days, the paper should be removed from the container and left to air-dry for 1-2 days. Fold paper in two with the side containing the eggs on the inside.	42
Mosquito identification (larval specimen)	Specimen collected and killed in hot but NOT boiling water	Specimen should be sent in vials containing 70% ethanol.	7
Mosquito identification (adult specimen)	Specimen killed with chloroform, ether, carbon dioxide or rapidly frozen in a domestic refrigerator	The specimen should be packaged and sent in a small vial or cardboard box lined with grease-proof paper or paper towels.	7
Arbovirus detection in mosquitoes (Mosquito-based Surveillance)	Adults sorted by species Mosquito Eggs	Demonstration of the presence of Dengue viruses (1-4), Chikungunya virus, Zika virus, Western Equine Encephalitis virus, Yellow Fever virus, Mayaro, Ilheus, Bussuquara virus, Usutu virus, Spondweni virus, O'nyong nyong virus, Eastern Equine encephalitis virus, Semliki forest virus or Rocio virus in mosquitoes.	7

CARPHA HEAD OFFICE

16-18 Jamaica Blvd,
Federation Park,
Port of Spain,
Trinidad & Tobago
(+868) 299-0820
(+868) 299-0895
(+868) 622-4261
postmaster@carpha.org

CARPHA JAMAICA

Hope Gardens,
Kingston 6,
Jamaica
(+876) 977-3540
(+876) 702-4235

CARPHA ST. LUCIA

P.O. Box 1111,
The Morne, Castries,
Saint Lucia
(+758) 452-2501
(+758) 452-1087
(+758) 453-2721

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Laboratory Testing Services

Laboratory Testing Services

Specialized Test Panels

DIARRHEAGENIC E. coli / Shigella

Entomology Specimen Referrals

CARPHA HEAD OFFICE

CARPHA JAMAICA

CARPHA ST. LUCIA

Email Us

DIARRHEAGENIC
E. coli / Shigella